Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure that involves replacing a damaged aortic valve using a catheter, typically inserted through a small incision in the leg, leading to faster recovery and reduced risks compared with traditional open-heart surgery. It is a common procedure; however, it is not without adverse events. We report a case of an 83-year-old man who underwent TAVR for the indication of severe symptomatic aortic stenosis. Shortly thereafter, he complained of progressive shortness of breath and was hospitalized for acute on chronic heart failure. Transesophageal echocardiography (TEE) was the first indication of a potential aorta to right ventricular fistula, and this was confirmed by a cardiac computed tomography angiography (CTA). He underwent a period of medical observation but did not do well, requiring re-admission to the hospital for acute on chronic heart failure. He was ultimately treated by percutaneous low-profile shunt closure using a septal occluder device. Percutaneous shunt closure in symptomatic patients using percutaneous low-profile shunt closure devices seems to be the best treatment option in high surgical risk patients.
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http://dx.doi.org/10.1177/23247096231191875 | DOI Listing |
Brain Spine
December 2024
Department of Neurosurgery, Hospital de Braga, R. das Sete Fontes, 4710-243, Braga, Portugal.
Introduction: Aneurysmatic subarachnoid hemorrhages (aSAH) are life-threatening events with high mortality and morbidity. Hydrocephalus is a common complication, initially managed with an external ventricular drain (EVD). Persistent hydrocephalus often requires ventriculoperitoneal shunt (VPS) placement to relieve intracranial pressure and prevent further neurological damage.
View Article and Find Full Text PDFWorld J Pediatr Congenit Heart Surg
January 2025
Division of Cardiac Surgery, University of Toronto, Toronto, ON, Canada.
The presentation of pulmonary vasculature in pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries (PA/VSD/MAPCA) is highly variable-as is the number, size and position of the MAPCAs and their relationship with the native pulmonary artery system. The priority in the management of this disease should be attaining timely and complete unifocalization, as opposed to single-stage full repair in every case. The merit of early unifocalization is that it secures the pulmonary vascular bed by (a) avoiding loss of lung segments from progressive stenosis/atresia of MAPCA origins, (b) preventing lung injury from high pressure/flow in areas fed by large, unobstructed MAPCAs, and (c) restoring central continuity of the pulmonary vasculature.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
September 2024
Department of Cardiovascular Surgery, Corewell East William Beaumont University Hospital, Royal Oak, Michigan.
Coronary-pulmonary artery fistulas (CPAFs) are rare entities that can cause significant left-to-right shunting and complicate routine coronary artery bypass grafting. There are no best practice guidelines and a scarcity of reports regarding concomitant treatment of CPAF with coronary artery disease. We present a case of bilateral CPAFs in a 60-year-old man with symptomatic coronary artery disease treated successfully with coronary artery bypass, epicardial ligation, and transpulmonary closure of CPAF with patch reconstruction.
View Article and Find Full Text PDFInt J Emerg Med
January 2025
Departamento de Cardiología, Fundación Valle del Lili, Carrera 98 No. 18 - 49, Cali, 760032, Colombia.
Background: Penetrating cardiac trauma is an entity with high pre and intrahospital mortality due to complications such as cardiac tamponade and massive hemothorax. A ventricular septal defect (VSD) occurs in 1-5% of cases and can present early or late. The management strategy for VSD resulting from penetrating cardiac trauma is uncertain.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Nephrology and Rheumatology, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China.
We aimed to evaluate the incidence of residual shunt after patent foramen ovale (PFO) closure and analyze the anatomical features of PFO to determine the risk factors for significant residual shunt after PFO closure. Ninety-two patients who underwent PFO closure at our center between September 2021 and June 2022 were consecutively enrolled. Transthoracic saline contrast echocardiography was performed at 6 and 12 months postoperatively to evaluate the presence of a significant residual shunt.
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